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55 Cards in this Set
- Front
- Back
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pleomorphic adenoma
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- Most common tumor
- painless, movable mass - benign high rate of recurrence |
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Warthin's tumor
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- benign
- heterotropic salivary gland tissue trapped in a lymph node - surrounded by lymphatic tissue |
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Mucoepidermoid Carcinoma
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- most common malignant salivary tumor
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Achlasia
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loss of myenteric (Auerbach's) plexus
- inc risk of esophageal carcinoma - High LES opening pressure = esophageal dymotility involving low pressure proximal to LES is SCLERODERMA |
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Esophageal varice
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- painless bleeding in lower 1/3 of esophagus in submucosla veins
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Mallory-Weiss syndrome
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-lacerations at the GE jxn due to severe vomiting.
- Painful |
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Boerhaav syndrome
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transmural esophageal rupture due to violent retching
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GERD
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Glandular METAPLASIA
- replacement of nonkeritonized stratified squamouse epithelium w/ - intestinal columnar epithelium |
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Celiac sprue antibodies
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- antbodies to
- GLIADIN - TISSUE TRANSGLUTAMINASE - inc risk of T-cell lymphoma |
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Curling's ulcer
Cushing ulcers |
ACUTE GASTRITIS
Curlings = dec volume -> sloughing of mucosa due to burns Cushing -> inc vagal stimulation -> inc ACh -> inc H+ production |
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Type A chonic gatritis
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- nonerosive
- fundus/body - destruciton of parietal cells - assoc. w autoimmune disorders |
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Type B chronic gastritis
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- antrum
- most common type - caused by H. pylori - inc risk of MALT lymphoma |
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Menetrier's diseaes
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- Gastric hypertrophy
- protein loss (hypoalbuminemia and edema) - parietal cell atrophy and inc mucous cells - precancerous - rugae of stomach are so hypertrophied that they look like barin/gyri |
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Stomach Cancer
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- type A blood
Intestinal type = known risk factors diffuse type = no known risk; signet ring |
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Duodenal ulcers
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- pain decreases when eating
- never cancerous |
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Crohn's
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- disorderd response to intestinal bacteria
- skip lesions and rectal sparing - TRANSMURAL inflammation - Cobblestone mucosa, creeping FAT bowel thickening ("string sign") - fissures and fistulas - Noncaseating granulomas tx = corticosteroids, infliximab (Ab TNF) |
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UC
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- Autoimmune
- continuous colonic lesions, always w/ RECTAL involvement - MUCOSAL and SUBMUCOSAL inflmmation - friable mucosal pseudopolyps w/ freely hanging mesentery - loss of HAUSTRA -> "LEAD PIPE" - Crypt abscesses and ulcers, bleeding, NO GRANULOMAS - toxic megacolon and colorectal carcinoma - bloody diarrhea - primary scleroisng cholangitis tx: ASA (sulfasalzaine); 6-mercaptopurine; infliximab - colonectomy cures - SMOKING MAY PREVENT DISEASE |
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Diverticulum
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- allow bacterial overgrowth -> B12 and bile salt deficiency
- false: only mucosa and submucosa outpouch. occur where vasa recta perforate muscularis externa |
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Diverticulosis
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- common in older population
-inc intraluminal pressure and weakness of abdominal wall. - Assoc. w/ low-fiber diets - usually is sigmoid - vague discomfort of painless rectal bleeding |
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Diverticulitis
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= LLQ appendicitis
- colovesicle fistula = pneumaturia - perforate = peritonitis, abscess formation, bowel stenosis |
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Hirschsprung's disease
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- failure of neural crest cell migration
- lack of ganglion cells/enteric nervous plexuses (Auerbach's and Meissner's plexuses) - Risk increases w/ Down Syndrome - failure to pass meconium |
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Duodenal atresia
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- adhesion distal to common bile duct = BILIOUS VOMITING w/ proximal stomach distention
- "Double Bubble" - due to failure of recanalization of small bowel - assoc. w/ DOWN SYNDROME |
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Meconium ileus
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- CF
- meconium plug obstructs intestine, preventing stool passage at birth |
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Necrotizing enterocolitis
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- necrosis of intestinal mucosa and possible perforation
- colon is usually involved - more common in preemies = dec immunity |
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Ischemic colitis
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- reduction in intestinal blood flow causes ischemia
- pain after eating -> weight loss - commonly occur at splenic flexure and distal colon |
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Angiodysplasia
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- tortuous dilation of vessels -> bleeding (anemia)
- found in cecum, terminal ileum, and ascending colon - confirmed by angiography - Assoc. w/ vWB disease and calcific aortic stenosis |
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malignant risk in colonic polyps
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- increase size
- villous histology - inc epithelial dysplasia |
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Hyperplastic polyp
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- most common non-neoplastic polyp
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Juvenile polyp
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- most sporadic lesions in children < 5 yrs of age. 80% in rectum
- if single, no malignant potential - juvenile polyposis syndrome - multiple juvenile polyps in GI tract, inc. risk of adenocarcinoma |
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Peutz-Jeghers
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AD
- multiple nonmalignant hamartomas thru/out GI tract - Assoc w/ inc risk of CRC and other visceral malignancies Histo = red and purple |
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FAP
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- AD
- APC gene on chromosome 5q - two-hit hypothesis - 100% to CRC - left-sided = circumferential - obstruction) |
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Gardner's syndrome
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AD
FAP + osseous and soft tissue tumors (osteoma, thyroid cancer, fibromas) - retinal hyperplasia |
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Turcot's syndrome
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-AR
FAP + malignant CNS tumor |
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HNPCC/Lynch
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- AD
- mutation of DNA mismatch repair genes ~80% progress to CRC - Proximal colon is always involved -> right-sided (exophytic-grows outward and therefore bleeds) |
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Risk factors of colorectal carcinom
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- IBD
- Strep bovis - tobacco - large villous adenomas - juvenile polyposis syndrome - Peutz-jeghers |
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Presentation of distal and proximal colon cancer
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DIstal Colon = obstruction, colicky pain, hematochezia
Proximal Colon = dull pain, iron def, anemia, fatigue |
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Tumor marke of CRC
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CEA tumor marker
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Molecular pathogenesis of CRC
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1. APC/Beta-catenin
loss of APC (5q) -> KRAS -> loss of p53 2.) mircosatellite DNA mismatch repair gene mutations -> sporatdic and HNPCC syndrome - mutations accumulate |
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Micro and macronodular insult
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Micronodular = < 3mm; metabolic insult (alcohol, hemochromatosis, Wilson's)
Macronodular = > 3mm; postinfxous or drug-induced hepatitis - inc risk of HCC |
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Reye's syndrome
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- fatty liver (microvesicular fatty change)
- hypoglycemia, coma Aspirin metabolites dec beta-oxidation by reversible inhibition of mitochondrial enzyme |
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Alcoholic hepatitis
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- Mallory bodies
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Increase HCC factors
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- Hepatitis B and C
- Wilson's disease - Hemochromatosis - alpha-1-antitrypsin def - alcoholic cirrhosis - carcinogens (aflatoxin in peanuts) - JAUNDICE, ASCITES, POLYCYTHEMIA, and hypoglycemia - inc AFP - can have budd-chiari syndrome |
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Cavernous hemangioma
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- MC benign tumor
- cavernous blood filled sinuses |
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Hyperbilirubinemia; Urine bilirubin-direct; Urine urobilinogen-formed in GI
Hepatocellular Obstructive Hemolytic |
Hepatocellular jaundice
- conj/unconj hyperbilirubinemia - urine bilirubin- direct = increase - urine urobilinogen (formed in GI) = Normal/decrease Obstructive jaundince - Hyperbilirubinemia = conjugated - urine bilirubin = increase - urine urobilinogen = decrease (none entering GI) Hemolytic jaundice hyperbilirubinemia = unconjugated urine bilirubin-direct = absent (acholuria) Urine Uroblinogen = increase |
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Gilbert's
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- mildly dec UDP-glucuronyl transferase or decrease bilirubin uptake
- elevated UNCONJUGATED - fasting and stress |
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Crigler-Najjer type I
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- AR
- absent UDP-glucuronyl transferase; presents early in life - KErnicterus - pts die - increase UNCONJUGATED bilirubin type II less severe = responds to phenobarbital which inc Liver fxn tests |
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Dubin-Johnson
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- CONJUGATED hyperbilirubinemia due to defective liver excretion
- blakc liver - multidrug resistant protein 2 Rotor's = similar but milder |
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Wilson's
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- AR
TX = Penicillamine |
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Hemochromatosis
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- AR
- HLA-A3 - cirrhosis, Diabetes, skin pigmentation - results in CHF and inc risk of HCC Tx = repeated phlebotomy and DEFEROXAMINE |
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Primary biliary cirrhosis
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- autoimmune rxn
- lymphocytic infiltrate + granulomatous destruction of portal triad (CD8) - inc serum MITOCHONDRIAL ANTIBODY - assoc. w/ autoimmune conditions |
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Primary sclerosing cholangitis
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- concentric "onion skin' bile ducts fibrosis
- alterating strictures and dilation w/ "beading" of intra- and extrahepatic bile ducts on ERCP - Ulcerative colitis - Labs = inc IgM (hypergammaglobinemia) - MCC cholangiocarcinoma |
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Anit-smooth muscle Ab
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autoimmune hepatitis
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Causes of Acute pancreatitis
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GET SMASHED
Gallstones Ethanol Trauma Steroids Mumps Autoimmune disease Scorpion sting HyperCalcemia/HyperLIPIDemia ERCP Drugs (sulfa drugs) |
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clinical pancreatitis
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- DIC, ARDS
- Pseudocyst = amylase inc after 10 days Abscess = sepsis, fever Ascites = pseudocyst leak; fluid inc amylase |
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Pancreatic Adenocarcinoma
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- CEA
- CA-19-9 - assoc w/ cigarettes and chronic pancreatitis but no EtOH - Migratory thrombophlebitis - Obstructive jaundice w/ PALPABLE GALLBLADDER (courvoisier's sign) |
